Organization
DELTA EMERGENCY GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIM GUIDRY (AUTHORIZED REPRESENTATIVE)
(800) 893-9698
Entity
Organization
Contact information
Practice address
1400 E UNION ST, GREENVILLE, MS 38703-3246
(662) 378-3783
Mailing address
200 CORPORATE BLVD, SUITE 201, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
05/03/2011
Last updated
05/03/2011
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